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Healthy Body


Worried About High Cholesterol?
Here's What to Do

November 2023

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By Melissa Chefec

That juicy burger with bacon and cheese might sound appetizing to some, but if you follow the statistics, you’re keeping an eye on your cholesterol. For many, bloodwork results might indicate a need to cut back on foods high in saturated fat (and trans fat) content, such as red meats, fried foods, processed meats, baked goods, and full-fat dairy products.
 
According to the World Heart Federation, high cholesterol causes 4.4 million deaths per year (or 7.8% of all deaths). The National Heart, Lung, and Blood Institute (NHLBI) reports, “Men are more likely than women to have unhealthy cholesterol levels, but women’s risk goes up after menopause.” So, women need to be concerned about their numbers once they reach a certain age. The NHLBI also states women ages 55 to 65 get cholesterol levels tested every one to two years. After age 65, cholesterol levels should be tested every year.
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​Cholesterol plays an important role in maintaining health,” says Dr. Robert Pilchik, a cardiologist with Manhattan Cardiology and contributor to LabFinder.com. “It’s important for cellular maintenance, digestion, and hormone production. It only becomes problematic when cholesterol levels – and particularly LDL cholesterol – become too high. But the consequences of high cholesterol can be severe,” Dr. Pilchik adds.
 
Cholesterol is a substance produced by the liver that has a waxy texture and moves through the bloodstream by attaching to a fatty substance called lipoprotein. Low-density lipoprotein (LDL) is sometimes called “bad cholesterol,” and high amounts are associated with negative health effects. High-density lipoprotein (HDL) is known as “good cholesterol” and can help lower the risk of certain diseases.
 
The body produces all the cholesterol it needs in order to function, but additional cholesterol can also be consumed with food.
 
Triglycerides are not technically cholesterol, but they are related. When the body has more energy than it needs, it can store it in the form of triglycerides – a type of fat – that can increase the risk of many health conditions, especially when someone also has high cholesterol levels.
 
“Blood cholesterol levels are measured in mg/dL. Having 150 mg/dL of total cholesterol is a good healthy target, and levels above 200 mg/dL are considered high,” says Dr. Pilchik.
LDL cholesterol should ideally be around 100 mg/dL, and triglycerides should remain below 150 mg/dL. HDL cholesterol should be 40 mg/dL or higher for men, and 50 mg/dL or higher for women.

​​Blood cholesterol levels can be measured with a simple blood test, and it’s a good idea for healthy adults to have it checked during each annual physical.
 
“As total cholesterol and triglyceride levels increase, plaque begins to build up in blood vessels and arteries. This increases blood pressure, puts strain on the cardiovascular system, and increases the risk of heart disease, heart attack, and stroke,” explains Dr. Pilchik.
 
“And the best way to avoid these effects is to prevent high blood cholesterol to begin with,” Dr. Pilchik adds.
“As total cholesterol and triglyceride levels increase, plaque begins to build up in blood vessels and arteries. This increases blood pressure, puts strain on the cardiovascular system, and increases the risk of heart disease, heart attack, and stroke."
​                                ~ Robert Pilchik, M.D.
A Look at Prevention
 
Make Dietary Changes if Needed
 
The first and perhaps most controllable way to prevent high cholesterol is to make healthy decisions about what to eat and what not to eat.
Avoid foods that are high in:

  • saturated fat
  • trans-fatty acids (trans fats)
  • sodium (salt)
  • added sugars
 
Instead, try to consume a diet high in fiber and unsaturated fat. The Mediterranean Diet is often a good choice, which shifts focus away from dairy and red meat and onto seafood, fruits and vegetables, nuts and seeds, and whole grains.
 
Track Physical Activity
 
“In the United States today, there are an extraordinary amount of people who are not maintaining what would be considered a healthy amount of physical activity,” says Pilchik.
 
Adults need at least 2.5 hours of moderate physical activity per week. This can include moderately-paced walks, cycling, or other types of exercise that maintains an elevated heart rate.
 
Exercise can be habitual, and forming habits early can be helpful for preventing health issues later in life. Children and adolescents need at least 1 hour of physical activity every day.
 
Maintain Healthy Weight
 
Maintaining a healthy weight has numerous health benefits, one of which is improving the body’s ability to use and remove excess blood cholesterol. While not a perfect tool, a Body Mass Index (BMI) calculator can help indicate whether a person’s weight is healthy or not.
 
If weight loss is an appropriate goal, dietary and activity choices may be helpful in achieving a healthy weight. A doctor can help determine if specific weight loss goals or plans are safe to pursue.
 
Avoid Smoking
 
“Smoking is generally very hard on a person’s cardiovascular system on its own, and the effects can be exacerbated by high cholesterol,” warns Pilchik.
 
For people who have never smoked or who have already quit, maintaining that lifestyle can be beneficial for heart health. For those who do smoke, quitting can ease strain on the heart and allow some amount of healing.
 
Minimize Alcohol
 
Along with smoking, alcohol consumption can have negative effects on the body including increased cholesterol and triglyceride levels.
 
While avoiding alcohol entirely isn’t always necessary, alcohol consumption should be limited to two drinks per day for men, and one drink per day for women at a maximum.
 
When Considering Medication
 
All of the aforementioned methods can help to prevent high cholesterol as well as help lower cholesterol levels after they’re already elevated.
 
After these other methods have been examined, it might be appropriate to take medication to help control cholesterol levels.
 
There are several types of cholesterol medications, such as:

  • statins
  • bile acid sequestrants
  • niacin
  • fibrates
  • PCSK9 inhibitors
 
“Medications are a very important and helpful tool in fighting high cholesterol, but all medications also include some risk of side effects. Getting ahead of high cholesterol with healthy choices earlier in life is always the preferred option,” Pilchik explains.

Robert Pilchik, M.D., is a cardiologist with Manhattan Cardiology, the premier facility for cardiac testing and preventive treatment in New York. He has multiple board certifications with expertise in cardiovascular disease and nuclear cardiology and contributes to LabFinder.

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Additional Resources:
Mayo Clinic
​Centers for Disease Control and Prevention
British Heart Foundation
NHLBI

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